Our Experiences with Distal Vascular Aneurysms

The distal cerebral aneurysma are rare. These incidentes mostly in catchmen area distal anterior cerebral artery (2.0–9.5%), aneurysma in distal part of middle cerebral artery are more rare with localisation in middle part of insula or posterior part of insula or in parietal area. In our series we have. 13 distal cerebral arterial aneurysma, 3 in insula (M4–6), 1 in gyrus precentralis, 1 in parietal lobe, 6 in distal naterior cerebral artery (A2–4), under Pertuiset and coworkers. Typ 3–5, so-call supracallosal, 2 aneurysms in distal basilar region - peripheral or distal part of PICA. Of all 11 saccular type and 3 fusiform type. 8 acute surgery procedures were made good and 5 delay. Mortality was 1 patient on masive pulmonary embolus 21 deays after surgery in case acute surgery procedure supracallosal aneurysma A3–4 left. We had the complications: organic psychosyndroms 8, lateralisation 0, hydrocephalus acute 1, but after external drainage with time after acute subarachnoid haemorhage was stabilized, next the patient was without hydrocephalic syndrom, epileptic seizure 0, cognitive lesion 0. The surgery was follow through craniotomy with clipping aneurysma or about fusiform aneurysma was follow through compression dissecting wall from outsider with help rubber band and clip, always with peroperative navigation. There is dealed with more rare localisation of aneurysma, their treatment was mostly in acute stage, but only in 3 cases, from their two fusiform aneurysma delaylly. Ther mortality was 1 case on comorbidity, in all cases are very high procentage of organic psychosyndrom in acute stage after operation, in cases delayed surgery was incidence of organic psychosyndrom minimally.